Smoked Two Cigarettes 48 Hours Before BA Surgery is that OK?

Hi! My BA surgery is on Friday at 9AM...48 hours essentially. I am not an occasional smoker but today I smoked two cigarettes and also three cigarettes last week. I am 24 years old, healthy, etc. I did smoke for two years in college but the past five months, I have occasionally smoked while drinking. Over the past week (leading up to my BA), I smoked a total of 8 cigarettes, last Wednesday and then two cigarettes today. Should I cancel my BA surgery on Friday ? Thank you for your help!

Doctor Answers (11)

Smoking and surgery

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Here are the major points of smoking Tobacco or Marijuana before or after surgery:
1. There is nicotine in tobacco, but not in marijuana. However, most joints are rolled with marijuana and tobacco combination. Nicotine is a vasoconstrictor that decreases blood flow to the tissues. This is the major problems that can cause a very bad outcome in some surgeries. In a breast augmentation, there is not a lot of risk as there are not a lot of incisions which decrease blood flow to the tissues. In a breast lift or tummy tuck, on the other hand, there is much longer and more involved incisions. The decrease in blood flow to the tissues in combination with the decrease in blood flow from the nicotine can cause tissue to die. This can cause part of the breast or nipple, or in the case of a tummy tuck, part of the belly tissue to die, resulting in a very bad outcome. Marijuana without tobacco does not cause this problem, or marijuana in an edible fashion. Vaporizers do not decrease the amount of nicotine in tobacco, only decrease the smoke.
2. There is carbon monoxide in both tobacco smoke and marijuana smoke. Carbon monoxide decreases the oxygen carrying capacity of hemoglobin in the blood. This is different from the vasoconstrictor effect, but has the same result of having the risk of tissue death in conjunction with surgeries that decrease the blood flow to tissues such as breast lifts and tummy tucks, as opposed to an augmentation alone that does not decrease blood flow to as great of an extent. Again, edible forms of marijuana do not have smoke, and thus carbon monoxide poisoning.
3. Coughing. Both tobacco and marijuana smoke disrupt the lining of the lungs and bronchi and can lead to coughing episodes. Coughing episodes can lead to internal bleeding after surgery that can lead to hematomas and complications, and again a bad outcome. Again, edible forms of marijuana does not have this effect.
4. Anesthesia effects. Marijuana can have drug interactions with certain anesthetic drugs. Thus it is important to tell your anesthesiologist about your marijuana use.
In conclusion, Smoking, whether it be tobacco or marijuana, is detrimental to your surgery outcome. Edible marijuana is much less so, but be honest about your use with your surgeon and anesthesiologist so that you can have the best outcome. In general, you should quite smoking many weeks, ideally 6 weeks before surgery, and not smoke for at least 2 weeks after surgery.
Best wishes,
Pablo Prichard, MD


Phoenix Plastic Surgeon
5.0 out of 5 stars 26 reviews

Smoked two cigarettes 48 hours before BA surgery - is that ok?

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Hello! Thank you for your question! The issue with nicotine is that it also acts as a vasoconstrictor, clamping down of blood vessels. Blood supply is always of great concern during any surgical procedure, but especially in such a procedure as breast surgery where the viability of the nipple-areolar complex is obviously important. Since the vascularity to the area is already tenuous since it will be raised by cutting around the area, maximizing blood flow to the tissue is critical.

Typically, we recommend at least 6 weeks of smoking cessation prior to any surgical procedure. Nicotine always increases the risk for infection and wound complications, as well as other health consequences. These couple cigarettes will likely not impact vascularity, but I would discuss this with your surgeon prior to your procedure.  Some surgeons will refuse to operate on smokers due to increased risk of infection, wound complications, scarring issues, blood clots, let alone the pulmonary complications that can occur with general anesthesia and afterwards.  Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 11 reviews

Smoking and BA

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Fortunately, smoking does not have the same kind of negative impact on a breast augmentation as it does on a breast lift.  So, unless you are having a lift with your BA, you shouldn't be at a significantly higher rate of risks.  I would, of course, advise quitting afterwards.

 

Hope everything goes well for you.

Thomas Fiala, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 25 reviews

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Thank you for the question.

Fortunately, it is very likely that you will do well  with the breast augmentation procedure despite smoking.  This does not necessarily hold true for patients undergoing more extensive surgery such as breast lifting, tummy tuck,  or face lifting surgery.

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Smoking is clearly not a good thing because it affects wound healing.  Clearly, your pre-op nerves manifested themselves this way!!  I recommend that you contact your plastic surgeon to discuss this because he must decide whether this is within his comfort level, rather than the RealSelf panel.  Best of luck.

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Sad to say, but smoking will not impact your breast augmentation

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Smoking is bad, and can impede healing and be a problem for cosmetic procedures, but the lick of it is that the risk of smoking and poblems with breast augmentation are very few. You need not cancel your surgery.

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Smoking and Surgery

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Any history of smoking increases the risk of poor wound healing prior to surgery.The number of pack years and the proximity to surgery also may have an adverse effect . A young otherwise healthy individual with a small ingestion of tobacco will result in a small increase in the overall risk.

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It is always best to be honest with your plastic surgeon and let him know that you are back to smoking.  He can evaluate the situation and let you know if there is a problem.  One or two cigarettes prior to surgery should not be a major concern.  In general we do not like patients to smoke in the peri-operative period, two weeks before and two weeks after surgery.  It can effect your healing.  No one wants any wound healing problems.  

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Smoking is harmful with respect to blood supply and healing, especially with certain procedures like facelifts and tummy tucks when a thin flap of tissue is created.  Smoking can also cause patients to cough more following anesthesia and this might increase discomfort and the risk of bleeding although I think that risk is quite low.  I assume you have discussed your smoking history with your surgeon but if you have not you should notify him/her tomorrow and make sure this will not be a problem.  

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.